Individual
JUANITA LEANN STATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1267 ENTERPRISE WAY NW STE B, HUNTSVILLE, AL 35806-4472
(256) 713-1872
(256) 713-1873
Mailing address
1267 ENTERPRISE WAY NW STE B, HUNTSVILLE, AL 35806-4472
(256) 713-1872
(256) 713-1873
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT4184
MS
225100000X
Physical Therapist
Primary
PTH4831
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT4184
MISSSISSIPPI STATE BOARD OF PHYSICAL THERAPY
MS
01
—
PTH4831
PHYSICAL THERAPIST LICENS
AL
Enumeration date
09/02/2006
Last updated
07/12/2021
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